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EMPLOYMENT APPLICATION

As an equal opportunity INSTRUCTIONS:


employer, Bench does not 1. Fill-up all blanks and answer all questions
discriminate in hiring or completely, if questions are not applicable
terms and conditions of write NA. Write Unknown only if you do
employment because not know the answer and cannot obtain the
of an individuals creed, answer from personal records.
sex, age, religion, disability 1 1/2 x 1 1/2 photo 2. Print legibly and write carefully.
or origin. 3. Use extra sheet of paper for further details
on any question you think has insufficient
/ / CORPORATION space.
Date of Application 4. You will be requested to present documen-
2214 Tolentino St., Pasay City tary evidence which supports the statements
you will made whenever hired.
Potition Applying for 5. The statements made herein are classified
and treated CONFIDENTIAL.

PERSONAL INFORMATION
Last Name First Name Middle Name

Present Address How long have Tel. No.


you lived there? ____ Years ____ Months
Permanent Address How long have Tel. No.
you lived there? ____ Years ____ Months
Date of Birth Place of Birth Sex Citizenship Religion
M F
Age Civil Single Separated No. of SSS No. TIN Pag-ibig No.
Status Married Widower Children

RELATION NAME AGE ADDRESS OCCUPATION EMPLOYER

WIFE/HUSBAND

FATHER

MOTHER

BROTHER/S
AND/OR
SISTER/S
(FROM OLDEST
TO THE
YOUNGEST)

CHILDREN

EDUCATION
No. of Years Graduated
Type of School Name of School Address Degree/Area of Study Attended (Check One)

ELEMENTARY

HIGH SCHOOL

COLLEGE
GRADUATE
SCHOOL

OTHERS
Government Nature of Date/s Rating/s
Exam/s Taken Exam/s Taken
Seminars/Trainings and Knowledge of Foreign
Dates of Attendance Languages & Local
Dialects

ACADEMIC AND PROFESSIONAL ACTIVITIES AND ACHIEVEMENTS


Academic and Professional Activities, Achievements, Awards, Publications or Technical-Professional Societies. Date Awarded
SKILLS
Skills applicable to position applied for

EMPLOYMENT HISTORY
List employment starting with your most recent position. Account for any time during this period that you were unemployed by stating the nature of your activities.
If you have less than four places of employment, include personal references to be contacted. May we contact your present employer? ( ) Yes ( ) No
POSITION HELD & REASON FOR
DATES NAME AND ADDRESS OF EMPLOYER SUPERVISOR LIST MAJOR DUTIES WAGES LEAVING
FROM: NAME YOUR JOB TITLE STARTING
/
MO. YR. ADDRESS
TO: SUPERVISOR FINAL
/ PHONE
MO. YR.
FROM: NAME YOUR JOB TITLE STARTING
/
MO. YR. ADDRESS
TO: SUPERVISOR FINAL
/ PHONE
MO. YR.
FROM: NAME YOUR JOB TITLE STARTING
/
MO. YR. ADDRESS
TO: SUPERVISOR FINAL
/ PHONE
MO. YR.
FROM: NAME YOUR JOB TITLE STARTING
/
MO. YR. ADDRESS
TO: SUPERVISOR FINAL
/ PHONE
MO. YR.

HEALTH AND PHYSICAL DATA


Height Blood Type Nature and Date of Most Recent Serious Illness/es Known Physical Defects

Weight

PERSON TO CONTACT IN CASE OF EMERGENCY


Full Name Address Tel. No. Relationship to you?

Employer (if any) Address Tel. No.

REFERENCES (3 Persons NOT Relatives NOR Former Employers)


NAME BUSINESS ADDRESS (IF POSSIBLE) TEL. NO. OCCUPATION/BUSINESS

MISCELLANEOUS
Is there any additional information involving a change of your name or assumed name that will permit us to check your work record?
If yes, please explain.
List Names of Friends or Relatives now employed by BENCH:

Have you ever been convicted of a crime?


If yes, please explain.

PLEASE READ THIS STATEMENT CAREFULLY


I hereby affirm that the information given by me on this application for employment is complete and accurate. I understand that any falsification or
ommission will be immediate grounds for dismissal. I authorize a thorough investigation to be made in connection with this application concerning my character,
general reputation, employment, education background and criminal record, whichever may be applicable. I understand what this investigation may include and
I hereby authorize the release of documents and personal interviews with third parties, such as prior employers, family members, business associates, financial
sources, friends, neighbors or others with whom I am acquainted. I further understand that I have the right to make a written request within a reasonable period
of time for a complete and accurate disclosure of the nature and scope of the investigation.
I have read and affirm as my own the above statements.

Signature Date